Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Article
  • Published:

NRBC concentrations over time in neonates with moderate to severe neonatal encephalopathy with and without sentinel events

Journal of Perinatology (2024)Cite this article

Subjects

Abstract

Objective

To study the serum concentrations of nucleated red blood cells (NRBC) over time in neonates with moderate to severe neonatal encephalopathy (NE).

Study design

A retrospective cohort study with subjects subdivided into three groups: definite sentinel events (n = 52), probable sentinel events (n = 20) and no history of sentinel events (n = 63). Peak absolute NRBC and NRBC/100 WBC were compared between groups and with MRI Injury score, cord and admission pH/base deficit.

Results

Absolute NRBC peaked at 24.05 h after birth (CI: 15.30-32.79), 17.56 h after birth (CI: 7.35-27.77), and 39.81 h after birth (CI: 28.73-50.89) in each respective group. The peak in absolute NRBC correlated with the severity of injury in the grey matter in group 2 and white matter in groups 1 and 2. Higher peak absolute NRBC value correlated to a lower admission ABG pH.

Conclusion

NRBC peak at 24 h after birth in neonates with sentinel events.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Fig. 1: Box plot graph of the peak absolute NRBC and NRBC/100WBC values among 3 cohort.
Fig. 2: Box plot graph of time to peak absolute NRBC among 3 cohort.
Fig. 3: Box plot graph of time to peak absolute NRBC/100 WBC among 3 cohort.

Similar content being viewed by others

Data availability

The datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request.

References

  1. Hermansen MC. Nucleated red blood cells in the fetus and newborn. Arch Dis Child Fetal Neonatal Ed. 2001;84:F211–5.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  2. Sills RH, Hadley RA. The significance of nucleated red blood cells in the peripheral blood of children. Am J Pediatr Hematol Oncol. 1983;5:173–7.

    PubMed  CAS  Google Scholar 

  3. Lippman HS. Morphologic and quantitative study of blood corpuscles in the newborn period. Am J Dis Child. 1924;27:473–515.

    Google Scholar 

  4. Walsh BH, Boylan GB, Murray DM. Nucleated red blood cells and early EEG: predicting Sarnat stage and two year outcome. Early Hum Dev. 2011;87:335–9.

    Article  PubMed  CAS  Google Scholar 

  5. Phelan JP, Ahn MO, Korst LM, Martin GI. Nucleated red blood cells: a marker for fetal asphyxia? Am J Obstet Gynecol. 1995;173:1380–4.

    Article  PubMed  CAS  Google Scholar 

  6. Hanion-Lundberg KM, Kirby RS, Gandhi S, Broekhuizen FF. Nucleated red blood cells in cord blood of singleton term neonates. Am J Obstet Gynecol. 1997;176:1149–54.

    Article  PubMed  CAS  Google Scholar 

  7. Ghosh B, Mittal S, Kumar S, Dadhwal V. Prediction of perinatal asphyxia with nucleated red blood cells in cord blood of newborns. Int J Gynaecol Obstet. 2003;81:267–71.

    Article  PubMed  CAS  Google Scholar 

  8. Hanlon-Lundberg KM, Kirby RS. Nucleated red blood cells as a marker of acidemia in term neonates. Am J Obstet Gynecol. 1999;181:196–201.

    Article  PubMed  CAS  Google Scholar 

  9. Yoon D, Ponka P, Prchal JT. Hypoxia. 5. Hypoxia and hematopoiesis. Am J Physiol Cell Physiol. 2011;300:C1215–22.

    Article  PubMed  CAS  Google Scholar 

  10. Yoon D, Pastore YD, Divoky V, Liu E, Mlodnicka AE, Rainey K, et al. Hypoxia-inducible factor-1 deficiency results in dysregulated erythropoiesis signaling and iron homeostasis in mouse development. J Biol Chem. 2006;281:25703–11.

    Article  PubMed  CAS  Google Scholar 

  11. Huang X, Pierce LJ, Chen GL, Chang KT, Spangrude GJ, Prchal JT. Erythropoietin receptor signaling regulates both erythropoiesis and megakaryopoiesis in vivo. Blood Cells Mol Dis. 2010;44:1–6.

    Article  PubMed  CAS  Google Scholar 

  12. Christensen RD, Lambert DK, Richards DS. Estimating the nucleated red blood cell ‘emergence time’ in neonates. J Perinatol. 2014;34:116–9.

    Article  PubMed  CAS  Google Scholar 

  13. Badawi N, Kurinczuk JJ, Keogh JM, Alessandri LM, O’Sullivan F, Burton PR, et al. Intrapartum risk factors for newborn encephalopathy: the Western Australian case-control study. BMJ. 1998;317:1554–8.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  14. Nelson KB, Bingham P, Edwards EM, Horbar JD, Kenny MJ, Inder T, et al. Antecedents of neonatal encephalopathy in the Vermont Oxford network encephalopathy registry. Pediatrics. 2012;130:878–86.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Kil TH, Han JY, Kim JB, Ko GO, Lee YH, Kim KY. et al. A study on the measurement of the nucleated red blood cell (nRBC) count based on birth weight and its correlation with perinatal prognosis in infants with very low birth weights. Korean J Pediatr. 2011;54:69–78.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Weeke LC, Groenendaal F, Mudigonda K, Blennow M, Lequin MH, Meiners LC, et al. A novel magnetic resonance imaging score predicts neurodevelopmental outcome after perinatal asphyxia and therapeutic hypothermia. J Pediatr. 2018;192:33–40.e2.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Gaulee P, Yang Z, Sura L, Xu H, Rossignol C, Weiss MD, et al. Concentration of serum biomarkers of brain injury in neonates with a low cord pH with or without mild hypoxic-ischemic encephalopathy. Front Neurol. 2022;13:934755.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Merrill HR, Tang X, Bliznyuk N. Spatio-temporal additive regression model selection for urban water demand. Stoch Environ Res Risk Assess. 2019;33:1075–87.

    Article  Google Scholar 

  19. Taylor-Rodriguez D, Womack A, Bliznyuk N. Bayesian Variable Selection on Model Spaces Constrained by Heredity Conditions. J Comput Graph Stat. 2016;25:515–35.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Shah V, Mahmood N, Perlman M. Are Nucleated red blood cells (NRBCs) Markers for timing the hypoxic-ischaemic insult? Pediatr Res. 1998;44:442.

    Article  Google Scholar 

  21. Li J, Kobata K, Kamei Y, Okazaki Y, Nishihara M, Wada H. et al. Nucleated red blood cell counts: an early predictor of brain injury and 2-year outcome in neonates with hypoxic-ischemic encephalopathy in the era of cooling-based treatment. Brain Dev. 2014;36:472–8.

    Article  PubMed  Google Scholar 

  22. Ferns SJ, Bhat BV, Basu D. Value of nucleated red blood cells in predicting severity and outcome of perinatal asphyxia. Indian J Pathol Microbiol. 2004;47:503–5.

    PubMed  Google Scholar 

  23. Hebbar S, Misha M, Rai L. Significance of maternal and cord blood nucleated red blood cell count in pregnancies complicated by preeclampsia. J Pregnancy. 2014;2014:496416

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pediatrics, University of Florida, Gainesville, FL, 32610, USA

    Pratima Gaulee, Livia Sura, Jamie Harris, James L. Wynn & Michael D. Weiss

  2. Departments of Agricultural and Biological Engineering, Biostatistics and Statistics, University of Florida, Gainesville, FL, 32611, USA

    Nikolay Bliznyuk

  3. Department of Radiology, University of Florida, Gainesville, FL, 32610, USA

    Dhanashree Rajderkar

  4. Department of Gynecology and Obstetrics, University of Florida, Gainesville, FL, 32610, USA

    Georgia Graham

Authors
  1. Pratima Gaulee
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Nikolay Bliznyuk
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Dhanashree Rajderkar
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Georgia Graham
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Livia Sura
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jamie Harris
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. James L. Wynn
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Michael D. Weiss
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Supervision: MW and JW; Study Design: MW, JW, PG and NB; Data Collection; PG, DR, GG, LS, JH and JW; Writing: PG, NB, DR, GG, LS and MW, Reviewing and editing: all authors.

Corresponding author

Correspondence to Michael D. Weiss.

Ethics declarations

Competing interests

The authors had no conflicts related to work in this manuscript.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Gaulee, P., Bliznyuk, N., Rajderkar, D. et al. NRBC concentrations over time in neonates with moderate to severe neonatal encephalopathy with and without sentinel events. J Perinatol (2024). https://doi.org/10.1038/s41372-024-01887-6

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1038/s41372-024-01887-6

Search

Advanced search

Quick links